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Oregon rates for HCPCS 22869

Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level

Facilitymedian $851 · 10th–90th $617–$7,9430%20%10th90th$851Professionalmedian $851 · 10th–90th $646–$1,1220%20%10th90th$851$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $7,943.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $851.14 / $1,047.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $707.95 / $1,148.15
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $891.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $707.95 / $1,023.29
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33,884.42 / $46,773.51 / $56,234.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $25,118.86 / $56,234.13